Evidence map›Paper›PMID 26070457›Full record

SynthesisCritical care (London, England)2015

Rapid response systems: a systematic review and meta-analysis.

Ritesh Maharaj, Ivan Raffaele, Julia Wendon

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 205 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
205citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04320056 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Automated Oxygen Titration - Monitoring and Weaning in Patients With Infectious Pneumonia Requiring Oxygen - Impact on the Number of Interventions for Healthcare Workers. An Innovative Device to Manage Patients With COVID-19 Pneumonia COVID Study (Closed-Loop Oxygen to Verify That Healthcare Workers Interventions Decreaseduring Pneumonia)

TypeinterventionalSponsorLaval UniversityRan2020 to 2021Enrolled216ConditionsCoronavirus, Pneumonia, Oxygen ToxicityArmsStandard administration of oxygen flow, Automated oxygen administration - FreeO2
NCT06051526 completednot on this mapstarted 2023, after this paper: background citation

The African Critical Illness Outcomes Study

TypeobservationalSponsorUniversity of Cape TownRan2023 to 2024Enrolled20,159ConditionsCritical Illness, Mortality
3 · Its place in the literature

Who cites it

205 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  8. Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2017
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145 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Ritesh MaharajKings College London, Denmark Hill, London, SE5 9RW, UK. ritesh.maharaj@kcl.ac.uk.
Ivan RaffaeleDepartment of Critical Care Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RW, UK. ivanraffaele@nhs.net.
Julia WendonKings College London, Denmark Hill, London, SE5 9RW, UK. Julia.wendon@kcl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAlthough rapid response system teams have been widely adopted by many health systems, their effectiveness in reducing hospital mortality is uncertain. We conducted a meta-analysis to examine the impact of rapid response teams on hospital mortality and cardiopulmonary arrest.

methodWe conducted a systematic review of studies published from January 1, 1990, through 31 December 2013, using PubMed, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and the Cochrane Library. We included studies that reported data on the primary outcomes of ICU and in-hospital mortality or cardiopulmonary arrests.

resultsTwenty-nine eligible studies were identified. The studies were analysed in groups based on adult and paediatric trials that were further sub-grouped on methodological design. There were 5 studies that were considered either cluster randomized control trial, controlled before after or interrupted time series. The remaining studies were before and after studies without a contemporaneous control. The implementation of RRS has been associated with an overall reduction in hospital mortality in both the adult (RR 0.87, 95 % CI 0.81-0.95, p<0.001) and paediatric (RR=0.82 95 % CI 0.76-0.89) in-patient population. There was substantial heterogeneity in both populations. The rapid response system team was also associated with a reduction in cardiopulmonary arrests in adults (RR 0.65, 95 % CI 0.61-0.70, p<0.001) and paediatric (RR=0.64 95 % CI 0.55-0.74) patients.

conclusionRapid response systems were associated with a reduction in hospital mortality and cardiopulmonary arrest. Meta-regression did not identify the presence of a physician in the rapid response system to be significantly associated with a mortality reduction.

Indexed as

Heart ArrestHospital MortalityHospital Rapid Response TeamHumansLength of StayRandomized Controlled Trials as Topic

Identifiers

PMID26070457
PMCPMC4489005

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.